肛门和尿道括约肌肌电图对多系统萎缩的诊断和鉴别诊断价值

Diagnostic significance of urethral sphincter electromyography and external anal sphincter electromyography in patients with multiple system atrophy

摘要:

肛门和尿道括约肌肌电图对多系统萎缩（MSA）具有诊断和鉴别诊断价值。本文综述了两种检查方法的解剖及病理生理基础、方法学、正常和异常表现以及在神经系统疾病中的诊断及鉴别诊断价值。目前, 两种检查方法对多系统萎缩诊断及鉴别诊断价值仍存在争议, 对MSA诊断的特异性及敏感性, 二者差异与临床特点的相关性, 以及是否可以互相弥补尚未见报道。肛门和尿道括约肌肌电图在MSA时表现为神经源性损害的改变, 在怀疑MSA时该项检查可作为常规的电生理检测手段, 对于鉴别诊断以及两者之间的相互关系尚有进一步研究的空间。

Abstract:

The urethral sphincter electromyography (US-EMG) and external anal sphincter electromyography (EAS-EMG) has certain significance for the diagnosis of multiple system atrophy (MSA). In this paper, we summarized the anatomical and pathophysiological basis of these two methods, and their methodology, normal and abnormal performance, as well as their roles in the diagnosis of the nervous system diseases. Currently, the significance of these two methods in MSA diagnosis remains controversial; the sensitivity and specificity in the diagnosis of MSA, and the correlations between the mutual differences and clinical characteristics have not been reported. Anal and urethral sphincter EMG manifested as neurogenic changes in multiple system atrophy, so that the examinations can be used as a conventional electrophysiological testing means in diagnosis of suspected MSA; however, further researches are needed for the differential diagnosis and their correlations.